Understanding the Treatment Foster Care Program: A Comprehensive Guide

Treatment Foster Family Care (TFFC) represents a specialized and highly supportive approach within the broader foster care system. This innovative program is meticulously designed to offer intensive, multidisciplinary treatment services to children with significant emotional, behavioral, or mental health challenges, all within the nurturing environment of a structured family home. Specifically tailored for children under the conservatorship of DFPS (Department of Family and Protective Services) who have experienced complex trauma and present high needs, TFFC aims to provide a pathway to healing and stability.

The primary objective of the Treatment Foster Care Program is to offer a stabilizing intervention for children who are at risk of being placed in more restrictive settings such as congregate care facilities or psychiatric hospitals. By focusing on emotional, behavioral, and mental health difficulties, TFFC facilitates successful transitions for children to less intensive, more permanent living arrangements as they progress through the program. This program is available for children aged 17 years and younger.

To help you determine if the Treatment Foster Care Program might be the right path for you as a prospective or current foster parent, we invite you to explore concrete examples of children who have benefited from the program and read inspiring success stories.

For those already involved in the program or seeking further clarification, please continue reading for a detailed program overview. You can also find answers to common questions in our dedicated Q&A section. If you have a specific question not addressed here, please do not hesitate to reach out to the TFFC mailbox for direct assistance.

What Sets Treatment Foster Care Homes Apart?

A Treatment Foster Family Care (TFFC) home is distinguished by its dedicated focus on actively involving the child’s next potential permanent caregiver from the outset of placement. For every child participating in TFFC, an identified caregiver is crucial, and this individual is engaged collaboratively with the foster parent throughout the placement duration. The TFFC treatment team ensures comprehensive support by including the identified caregiver in all treatment planning meetings. They also provide essential coaching, resources, and robust after-care services. This holistic approach is designed to equip the identified caregiver with the necessary tools and knowledge to continue meeting the child’s needs effectively after they transition from the TFFC program, thereby securing the child’s long-term success and well-being.

Treatment Foster Care homes offer several key features that differentiate them from traditional foster care settings:

Specialized Training for Foster Parents: TFFC foster parents receive in-depth, evidence-based parenting training focused specifically on addressing the mental and behavioral health needs of children with complex challenges. This specialized training equips them with advanced skills and strategies to provide effective care.
24/7 On-Call Case Management Support: To ensure the safety and security of each child, TFFC homes benefit from round-the-clock on-call case management. This includes frequent, individualized monitoring and the capacity for immediate on-site crisis response, providing continuous support and security.
Comprehensive Wraparound Services: Children in TFFC are supported by a highly trained multidisciplinary treatment team that delivers wraparound services. This team approach ensures all aspects of the child’s needs are addressed in a coordinated and comprehensive manner.
Low Child-to-Caregiver Ratio: TFFC homes maintain a low child-to-caregiver ratio, ensuring that professional foster parents can dedicate focused attention and personalized care to each child, fostering a more therapeutic environment.

Program Duration and Transition Planning in Treatment Foster Care

The DFPS Treatment Foster Family Care Program is structured as a short-term, intensive intervention, with placements typically lasting up to nine months. Recognizing that some children may require additional support, there is a provision for a one-time extension of up to three months. Such extensions must be authorized by the Associate Director of Placement, ensuring careful consideration and justification for extended care.

TFFC is designed to be a stepping stone towards permanency. If reunification with the biological family or adoption is not immediately feasible, the program prioritizes transitioning the child to a less intensive, traditional foster home setting. This step-down approach ensures continued care while promoting greater independence and integration into a more typical family environment.

Discharge planning is an integral part of the TFFC program and commences right from the beginning of a placement. CPS (Child Protective Services) is required to proactively plan for the child’s subsequent placement no later than 30 days after the child enters TFFC. This early planning ensures a smooth and well-prepared transition for the child following their time in the program.

To further support successful transitions, the State Office may schedule a meeting at the point of discharge. This meeting serves as a platform to discuss permanency options, evaluate progress made, and outline the next steps in the child’s care journey, ensuring a coordinated approach to long-term well-being.

After-Care Services: Continued Support Following TFFC

Understanding that the transition out of intensive treatment is a critical period, the Treatment Foster Family Care program includes robust after-care services. For a period of six months following discharge, the TFFC provider remains actively involved, offering ongoing support to the child and their subsequent placement.

These after-care services are comprehensive and may include:

Continued Behavioral Support: Ensuring consistent strategies and interventions are in place to maintain progress made during the program.
Regular Follow-Ups: Scheduled check-ins to monitor the child’s adjustment and address any emerging challenges.
Home Visits: Providing in-person support and observation in the child’s new living environment.
Respite Options: Offering temporary relief for caregivers to prevent burnout and ensure the sustainability of the placement.

In the event of a placement breakdown during the after-care period, the Treatment Foster Care provider is the first point of contact. Their established relationship with the child and family, coupled with their expertise, makes them invaluable in exploring and facilitating appropriate alternative placement options if necessary. This safety net of after-care services is crucial in ensuring the long-term stability and success of children who have participated in the Treatment Foster Care Program.

TFFC Providers in Texas

Currently, there are three Child Placing Agencies in Texas authorized to provide Treatment Foster Family Care services:

(List of specific Child Placing Agencies would be listed here if provided in the original article. In this case, the original article mentions there are three but does not list them. For a real article, this section would be populated with the names and contact information of these agencies.)

Examples of Children in the TFFC Program

To illustrate the types of children who benefit from the Treatment Foster Care Program, consider these examples, which are based on real situations (names have been changed to protect privacy):

Anna

Anna, a 12-year-old girl requiring a specialized level of care, is described as intelligent and affectionate, needing a stable, structured, and loving environment. Since a disrupted adoption in 2015, Anna has struggled with emotional rejection, leading to escalating behavioral issues. She experiences frequent tantrums, physical aggression towards peers, stealing, lying, property destruction, and bedwetting. In 2022, a severe tantrum involving property damage and self-harm led to a psychiatric hospitalization. Without intensive intervention, Anna was at high risk of needing a Residential Treatment Center (RTC) placement.

Psychological Evaluation (January 22, 2023) Diagnoses: Unspecified Disruptive, Impulse-Control, Conduct Disorder; Disruptive Mood Dysregulation Disorder; Attachment Disturbance.

Key Stressors: Long-term foster care, loss of biological family, multiple placement changes, adoption disruption, educational and social difficulties.

John

John, a 7-year-old boy also needing specialized care, was hospitalized in a psychiatric facility at the time of referral. He required placement upon discharge. John’s hospitalization followed an incident at school where he was found running in the hallways stating suicidal ideations. He exhibits emotional outbursts, tantrums when redirected (including rolling on the ground, covering ears, hitting walls), and physical aggression towards foster siblings. Despite these challenges, John is described as good-natured, talkative, and enjoys drawing. While he has expressed suicidal thoughts, he has not acted on them and is not currently a danger to himself or others. Academically, John has a composite IQ of 111 and attends regular second-grade classes.

Psychological Evaluation (March 30, 2023) Diagnoses: Major Depressive Disorder, Recurrent, Moderate; Attention-Deficit/Hyperactivity Disorder, Combined Presentation; Unspecified Trauma and Stressor Related Disorder.

Nicole

Nicole, a 16-year-old girl requiring an intense level of care, was awaiting placement after a recent discharge from a psychiatric hospital – her third in a year. Nicole presented with depression, anxiety, and self-harming tendencies. She struggles to express emotions constructively and has a history of sexual abuse and suicidal ideation. Nicole is on medication and attends special education classes in the 10th grade. Her IQ is 82. Despite her challenges, Nicole demonstrates insight, recognizes her triggers, and expresses a desire to manage her anger.

Psychological Evaluation (August 4, 2022) Diagnoses: Adjustment Disorder with Mixed Disturbance of emotions and conduct; Disruptive Mood Dysregulation Disorder; Depressive Disorder.

TFFC Success Stories

The Treatment Foster Care Program has facilitated significant positive changes in the lives of many children. Here are a few inspiring success stories:

Y.S.’s Story

Y.S., a 10-year-old girl with a history of depression and suicidal ideation, including self-harming behaviors, was placed in a TFC home with the goal of reunification with her biological mother. During her time in the program, Y.S. made remarkable progress. She was able to process her trauma, actively participate in creating a personal safety plan, and develop healthy coping mechanisms like journaling and seeking support from trusted caregivers. The TFFC team also worked closely with Y.S.’s mother, equipping her with crisis management skills, knowledge of Y.S.’s coping strategies and triggers. Upon program completion, Y.S. successfully reunified with her mother. Follow-up reports indicated that Y.S. and her family were engaged in ongoing therapy, Y.S. was thriving, and she was even able to discontinue her medication for depression and insomnia. Ultimately, her mother regained full custody of Y.S. and her sibling.

Alice and Trevor’s Story

Siblings Alice and Trevor entered CPS care due to neglect and abuse. Initially, their placement in the TFC program was marked by verbal and physical aggression towards each other, exacerbated by limited prior experience living together. However, through the program, Alice and Trevor demonstrated significant growth. Their aggressive episodes decreased substantially, and they became more open to new experiences, such as cooking, church activities, and art. Motivated by their foster parents, they improved their school performance and engaged in positive outings, including a trip to meet their foster family’s relatives. Alice and Trevor developed healthy coping and conflict resolution skills, leading to their successful program completion and a step-down to a moderate level of care, showcasing their remarkable progress.

A.S.’s Story

A.S., a 5-year-old boy with diagnoses including Generalized Anxiety Disorder, PICA, ADHD, and Enuresis, entered a TFFC home with a history of neglect. His treatment team identified sensory integration challenges, which manifested as disruptive behaviors like jumping on furniture and bumping into others. Responding to the team’s recommendations, the foster parent facilitated occupational and speech therapy for A.S. He also participated in individual therapy, learning about boundaries, coping skills, and verbalizing his needs. The foster parent reported a significant reduction in A.S.’s anger outbursts. He responded well to Trust-Based Relational Interventions, thrived with choices and compromises, and learned to meet his sensory needs through appropriate activities like trampolining and swinging. Remarkably, A.S. also overcame his PICA, stopped eating inedible objects, and progressed from being unable to stay in his car seat to managing short trips. A.S. successfully transitioned from the program to a traditional foster home, demonstrating substantial developmental strides.

José’s Story

José entered the TFFC program at age [Age not specified in original] due to aggressive behaviors towards his cousin, brother, and teachers. His cousin, his primary caregiver, was struggling to manage these behaviors and considering whether she could continue to care for him. Through consistent therapy, the structured program environment, and dedicated support, José gradually ceased these behaviors. Therapy included family sessions with the foster family, José, and his cousin, as well as sessions focused on José, his brother, and his cousin. José learned and utilized coping skills to manage his anger. He progressed through day and weekend visits and ultimately returned to his cousin’s care on June 30, 2022. José and his cousin maintain a positive relationship with his TFFC foster family, highlighting the program’s lasting positive impact.

Q&A About Treatment Foster Care

What if a child requires treatment beyond 9 months?

In cases where extended treatment is deemed necessary, the child’s CPS team and relevant parties should be consulted to assess the need for additional time.
If it is determined that the child is not ready for discharge within the standard timeframe, the Child Placing Agency must complete an extension request. This request is then submitted to the Centralized Placement Unit (CPU) for review by the child’s legal team.
CPS will manage the subsequent steps of the extension process to obtain necessary approvals.
It is crucial that the Treatment Foster Family Care extension request form provides clear and comprehensive supporting information that justifies the need for an extension. This includes detailing specific goals to be achieved during the extension period and outlining the services and plans in place to facilitate the child’s progress towards these goals.

What is the procedure for placement changes?

All placement changes or requests must be processed through the Regional Centralized Placement Unit.
Should a Child Placing Agency wish to move a child to a different Treatment Foster Family Care placement, prior notification and approval from the Centralized Placement Unit are mandatory.

What steps should be taken if a child is disrupting a placement?

In the event of a child disrupting a Treatment Foster Family Care placement, it is imperative to immediately notify the Centralized Placement Unit (CPU). This ensures that the CPU is promptly informed of all placement changes and any new requirements that arise.

What if a child needs to be moved to another foster home within the same agency?

If the treatment team concludes that transitioning a child to a new Treatment Foster Family Care placement within the same agency is in the child’s best interest, the caseworker must be informed and provide approval, including the completion of any necessary new paperwork. Subsequently, the DFPS Centralized Placement Unit must also be notified.
In the infrequent situation where a child transitions from one Treatment Foster Family Care home to another within the same agency, the original 9-month program timeframe will typically restart, unless an alternative arrangement is specifically requested and approved. However, any change in TFFC home placement, even within the same agency, necessitates approvals and due diligence checks by DFPS. In such cases, the contractor is required to submit Form 2109 Discharge Notice to the Caseworker, Supervisor, Regional Centralized Placement Unit (CPU), and the Treatment Foster Family Care mailbox.

When should the Centralized Placement Unit (CPU) be contacted?

The CPU should be contacted whenever there is any type of placement change. This includes disruptions, admissions to psychiatric hospitals (particularly when involving a 24-hour discharge notice), and any other alterations to the child’s living situation.
Child Placing Agencies are expected to have established protocols for respite care and transitions. It is important to note that CPU approval is not required for respite care arrangements.

How frequently is a child’s case reviewed?

The Child Placing Agency is responsible for submitting a child’s case to Youth For Tomorrow (YFT) under specific circumstances:
- 45 days prior to the anticipated discharge date.
- In the event of an emergency discharge.
It is crucial to ensure that the child’s case is submitted to YFT before the child leaves the TFFC home to prevent any lapse in service levels and continuity of care.
For any inquiries or to contact YFT, please email [email protected].

Where should a discharge notice be sent?

Discharge notices should be directed to the child’s Regional Centralized Placement Unit mailbox. In addition to the CPU, copies of the discharge notice should also be sent to the CPS caseworker, the caseworker’s supervisor, and the TFFC mailbox.

When is it necessary to send a discharge notice?

Form 2109 Discharge Notice must be submitted in the following situations:
- At least 30-45 days in advance of a planned successful discharge.
- In cases of emergency discharge or any other type of discharge that is not successful or planned.

Who should be notified about new openings in Treatment Foster Family Care homes?

To report new openings in Treatment Foster Family Care homes, please send an email notification to the TFFC mailbox.
Additionally, it is important to update the availability status in the General Placement Search (GPS) application. This ensures that the Centralized Placement Unit has real-time visibility of available placements.

What is the process if a referral is received?

Upon receiving a referral for Treatment Foster Family Care, it is essential to thoroughly review all referral details.
Respond to both the Centralized Placement Unit and the DFPS TFFC mailbox regarding each referral received. If there are no available homes that meet the child’s needs, promptly reply with “No home available”.

Who is eligible to become a Treatment Foster Family Care foster parent?

Ideal TFFC foster parents are individuals or couples who are highly trained and committed to meeting the unique and complex needs of the children in this program. While preference may be given to two-parent homes, single parents who can demonstrate their capacity to provide quality care are also eligible.
Quality of care is defined by the comprehensive fulfillment of all identified needs of the child, including medical, behavioral, cultural, educational, and spiritual needs. Employed individuals must demonstrate to the Contractor how their work schedule will allow for the flexibility required to meet the child’s individual needs. The Contractor continuously evaluates TFFC homes to ensure their ongoing ability to meet these needs, and the State Office TFFC Program Specialist is available to assist in these determinations when requested.

What should be done if CPS or a Judge requests therapy notes or other child-related records?

Therapy notes and other child-related records are vital for CPS workers and staff to gain a deeper understanding of a child’s strengths and needs, facilitating more informed decision-making.
Child Placing Agencies are legally obligated to make any and all records and information concerning a child available to DFPS upon verbal request in emergency situations. Emergency requests for records may include scenarios such as:
- Reviewing a child’s service level to assess the necessity of a placement change.
- Incidents requiring Emergency Behavior Intervention (EBI) Reports and Serious Incident Reports.
- Court-ordered requests for information.
- Requests from legal representatives or attorneys.
Treatment Foster Family Care contracts are governed by the RCC 24-Hour Requirements, except where exemptions or modifications are specified in the Programmatic Conditions, detailed in Section III of the Special, Supplemental, and Programmatic Conditions document, Attachment D.
Within the RCC 24-Hour Requirements, Section 1721 pertains to Providing Access to DFPS:

“DFPS has absolute right of access to, and copies of, Child case records or other information relating to a Child served by the provider. The provider makes available any and all records and information concerning the Child to DFPS upon written request. The provider must forward legible records and information to DFPS within 14 calendar days of receiving the request.”

Furthermore, it is important to note that record requests may also originate from the Texas State Auditor’s Office (SAO), the Federal Government, and their authorized representatives, and in such cases, provision of records is also mandatory.

If the TFFC provider is unclear about the CPS case details, who should be contacted?

In situations where a TFFC provider requires clarification or information regarding a CPS case, they should email the TFFC mailbox to request a consultation with a staff member. This will facilitate a discussion about the case and determine the appropriate next steps.

What if there are general inquiries about the TFFC program?

For any general questions or further information regarding the DFPS Treatment Foster Family Care program, please direct your inquiries to the DFPS Treatment Foster Family Care mailbox.